En analysant le fonctionnement psychologique de candidats au changement de sexe, nous avons observé ce qu'Exner a dénommé Snow White Syndrom. Ce syndrome se caractérise par une tendance à fuir les situations déplaisantes en se réfugiant de manière excessive dans l'imaginaire. Cette propension à se réfugier dans la passivité est tout à fait particulière : elle n'affecte pas les processus cognitifs et ne résulte pas d'un manque de ressources internes. Ainsi, les transsexuels semblent fuir les difficultés de la vie en se réfugiant dans un monde imaginaire qui leur permet ainsi d'éviter toutes responsabilités et prises de décision.

The Rorschach Ink Blot test is considered to be an essential analytical instrument when studying the personalities of individuals presenting identity disorders, in particular, in the context of a sex change request. Nevertheless, there exist less than 20 studies of transsexualism utilising the Rorschach since the creation of this diagnostic category in 1953. This research has mostly concerned itself with relations between psychopathology and transsexualism. Practically non-existent are studies investigating the psychological conditions that permit, shape or induce sex change requests in individuals. Transsexuals request the removal of their genitals through mutilation surgery, which can be seen as subjects literally crying out to be castrated. This request is all the more surprising given that castration, in psychoanalytic terms, is considered to be the most severe punishment that an individual (woman or man) can be threatened with. Therefore, we asked ourselves which psychic conditions could motivate such a request. Based on any earlier study where answers (some explicit, others symbolic) given by sex-change applicants tested on the Rorschach were analysed, results seemed to suggest a counter-phobic attitude underlying sex-reassignment requests <sup>[28MORMONT C, MICHEL A. La demande transsexuelle : quels mécanismes ? (Réflexions à partir de 28 Rorschach). Acta Psychiatr Belg 1996 ; 1 : 110-6.

Cliquez ici pour aller à la section Références]</sup>. According to these hypotheses, the fear of castration (banal as such) can only be overcome through the active search for castration itself. In opting for castration, the transsexual puts an end to the states of anxious waiting that are dominated by feelings of the incertitude and unpredictability of an eventual castration. Once obtained, the threat it constituted disappears, and with it so does the fear. Thus, by taking this active and voluntary step, the subject is no longer exposed to an imminent danger in a passive manner. This in itself creates a great feeling of relief, if not of actual pleasure in the subject <sup>[28MORMONT C, MICHEL A. La demande transsexuelle : quels mécanismes ? (Réflexions à partir de 28 Rorschach). Acta Psychiatr Belg 1996 ; 1 : 110-6.

Cliquez ici pour aller à la section Références]</sup>. In this article, we postulated in a purely speculative manner, the existence of one or several modalities in the transsexual dynamics. Nevertheless, one can ask oneself about the possibility of a request based on a desire rather than on a defense, or even on the existence of a defensive process diametrically opposed to the counter-phobic attitude and which, instead of actively provoking the dreaded reality, would privilege its avoidance and the search of passivity. This latter hypothesis has the advantage of being rather easy to explore with the Rorschach because, according to Exner, the predominance of passive compared to active human movement responses (which he terms the Snow White Syndrome) indicates the propensity to escape into passive fantasies and the tendency to avoid the initiative for behaviour or decision-making, if other people can do it in the subject's place <sup>[12EXNER JE. The Rorschach : a comprehensive system. Volume 2 : Curr Res Advanc Interpret. New York : Wiley, 1978.

Cliquez ici pour aller à la section Références]</sup>. Our results largely confirmed the hypothesis of the existence of an opposite mechanism, as a third of subjects (n = 26) presented Snow White Syndrome. According to Exner, these transsexuals are typically characterized by hiding into a world of make believe, avoiding all responsibility, as well as any decision-making. This passivity in our Snow White Syndrome group was all the more remarkable in that, on the whole, it infiltrated into all the movement responses and seemed to define a rigid style of thinking and mental elaboration, in addition to a suggestive content of passivity. However, this condition cannot be associated with a general lack of dynamism or energy. In fact, the treatment of information, which provides data concerning the motivation to treat a stimulus field of the stimulus – whether this concerns the capture (L) of the stimulus or the elaboration (DQ+) of the response – displayed a sufficient amount of motivation. Furthermore, internal resources (EA) were considerable and were brought into play whenever it was necessary to adopt a behaviour or make a decision. Furthermore, based on these Rorschach findings, we note that in transsexuals with Snow White Syndrome, there is a stereotyped tendency to shy away from difficulties by seeking refuge in realistic representations (but that lack in variety), which could be materialized by actions, but where the initiative is delegated to others. These transsexuals appear to shy away from the difficulties of life by seeking refuge into a world of fantasy, which they fill with the representations borrowed from reality (rather than fantasy) and consequently that are liable to be transposed, if necessary, back into reality. Therefore, one can better understand why they shun away from the deceiving reality that their physical sex represents, into the satisfying dream where they possess the genitals of the opposite sex, that is, a perfectly real organ, no longer the result of the subject's fantasy world.